The Case for Robotic-assisted Hysterectomies

Published March 2, 2017 by

Dr. Charles Miller (Advocate Lutheran General Hospital, Park Ridge, IL) writes a monthly column in OBGYN News called “Master Class”. This column is the most widely-read column in Gynecology, and Dr. Miller was recently the recipient of a Gold Award from the American Society of Healthcare Publication Editors for the best regular column.

In this column (click to link to view the article), Dr. Miller examines the current controversies surrounding the use of robotic surgery in Gynecology, and makes the case for the use of robotics as a key tool to deliver on the failed promise of laparoscopy to enable minimally invasive surgery for the majority of GYN patients.

Key takeaways from this column:

  • As a pioneer in the field of laparoscopy, Dr. Miller has witnessed firsthand skepticism towards new technology before. The negative statement from ACOG President James Breeden, the critical pieces in the mass media, etc. has all been seen before: history is repeating itself, this time with robotic surgery, and Dr. Miller lays out the evidence to support this in his editorial.
  • Dr. Miller carefully points out that the JAMA publication (Wright et al, 2013) not only proved that the use of robotic surgery in GYN is safe and effective (as evidenced by nearly identical complication rates with laparoscopy), but that this is being done with robotic surgery in its learning curve. He additionally states that “with increased surgeon experience, as with any new technology, the rate of complications would be expected to be further decreased.”
  • Data collection and scientific evidence inherently lags behind the adoption of surgical innovations: robotic surgery is no different in this respect. In the final paragraph, Dr. Miller acknowledges that “One can foresee, with the accumulation of knowledge and experience, that robotics will have a similar – if not even greater – role within our specialty.”